Nigeria's newborn survival gap remains a significant challenge, with an estimated 41 deaths per 1,000 live births, according to the 2024 Nigeria Demographic and Health Survey. This rate is far from the Sustainable Development Goal 3.2 target of at least 12 deaths per 1,000 live births by 2030. The country's progress in reducing under-five mortality has outpaced progress in the newborn period, with under-five mortality falling from 132 to 110 deaths per 1,000 live births between 2018 and 2024.
The case of Baby Aisha, born in Goni Kori village, Yobe State, in June 2016, highlights the challenges faced by newborns in Nigeria. Aisha was born with a rare congenital anomaly, ectopia cordis, and died before specialist cardiothoracic surgery could take place. Her case raises questions about the availability of skilled care, stabilisation, referral, transport, and specialist services for newborns in Nigeria. Many newborn deaths are preventable with quality antenatal and intrapartum care, competent health workers, and effective resuscitation, thermal and feeding support, infection prevention and treatment, and respiratory support.
The Federal Government launched the Maternal and Neonatal Mortality Reduction Innovation Initiative (MAMII) in November 2024 to address the newborn survival gap. MAMII targets 172 LGAs across 33 states and aims to reduce neonatal mortality by 20% in those areas by 2028. The initiative has been implemented in over 250 facilities in six states, with over 1,700 newborns reported to have received emergency obstetric and neonatal care. MAMII recognises that newborn survival depends on a continuum of care, from communities to primary healthcare facilities, comprehensive emergency obstetric and newborn care centres, and emergency transport and referral.
The National Primary Health Care Development Agency (NPHCDA) implementation model for MAMII connects communities, primary healthcare facilities, and comprehensive emergency obstetric and newborn care centres, while strengthening maternal and perinatal death surveillance and response. However, referral systems work only when facilities at each end are ready, with standards for functional Level 2 PHCs including 24-hour capacity for safe delivery, skilled birth attendants, reliable power, water and sanitation, essential equipment, and basic laboratory services.
Nigeria also needs stronger capacity to generate evidence, test solutions, and translate what works into routine practice. The Centre for Newborn Health Research and Innovation (CeNHRI) was commissioned in Ekiti State in June 2026, with a focus on evidence generation and research, simulation-based training, partnerships and innovation, and policy and knowledge translation. CeNHRI's simulation programme provides health workers with opportunities to practise essential and emergency newborn care in controlled clinical scenarios.
CeNHRI is part of a wider newborn-survival system, and its value will depend on whether its research informs national and state policy, whether training improves clinical practice beyond Ado-Ekiti, and whether locally tested solutions can be scaled through Nigeria's health system. Nigeria already has national guidelines for comprehensive newborn care and a Nigeria Every Newborn Action Plan, but implementation remains a challenge. Ensuring that health workers retain clinical skills, facilities have the staff, commodities, and equipment to use them, referral pathways function, and data on newborn deaths are used to improve services is crucial.
For newborns like Aisha, the system must work from early recognition, safe stabilisation, rapid transport, and access to specialist neonatal and surgical care when required. Nigeria already knows many of the interventions that save newborn lives, but the next challenge is to make them consistently and equitably available wherever a child is born. Research and innovation matter most when they help close the gap between what the evidence says should happen and what a newborn actually experiences.
Key points
- Nigeria's newborn survival gap remains significant, with 41 deaths per 1,000 live births.
- Initiatives like MAMII and CeNHRI aim to address the newborn survival gap through a continuum of care and evidence-based research.
- Implementation and ensuring that health workers retain clinical skills, facilities have necessary resources, and referral pathways function are crucial to reducing newborn mortality.
